=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922215029
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NANCY J CAPERS M.F.T.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/17/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1110 TORREY PINES ROAD #L
-----------------------------------------------------
City | LA JOLLA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92037-6004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 858-232-9697
-----------------------------------------------------
Fax | 858-459-0246
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1110 TORREY PINES ROAD #L
-----------------------------------------------------
City | LA JOLLA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92037-6004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 858-232-9697
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | MFC 41057
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------